How Trump's presidency might affect women's health in New York

Mount Sinai sells lab-testing unit to LabCorp

Mount Sinai Health System agreed to sell seven patient service centers to LabCorp of Burlington, N.C., adding to the publicly traded company's 120-center network in the New York metropolitan area. Terms of the deal, which is expected to close by the end of March, were not disclosed. The deal will affect patients "seen in our physicians' offices," the health system said in an emailed statement to Crain's. "This particular business, while successful, is no longer a core business of Mount Sinai," the statement continued. "Mount Sinai patients will benefit from LabCorp's scale and expertise in providing routine high-quality testing services at a lower cost and a wider network of service centers." The health system will continue to provide lab testing to patients at its hospitals and ambulatory care facilities. Citi advised Mount Sinai in the deal. —J.L.

HCRA taxes inflate health insurance costs for families, report says

Twenty years after Gov. George Pataki signed the Health Care Reform Act of 1996, deregulating hospital fees, New York state has become reliant on $5.5 billion each year in tax revenue generated by the law, according to a new report authored by Bill Hammond of the Empire Center for Public Policy. Hammond wrote that the taxes on health insurance "add as much as 6.2% to a typical family's health insurance costs" and are used to subsidize doctors' medical malpractice insurance and health care workers' pay and benefits and, at times, to help balance the state budget. In addition, Hammond criticized the way in which the state has distributed money from the Indigent Care Pool, which is supposed to reimburse hospitals for care they provide to the uninsured. The methodology for distributing about $1 billion isn't based on how much free care hospitals provide. Rather, it distributes money based on how much aid they have received in the past, Hammond wrote. The report's recommendation that Gov. Cuomo and the Legislature make changes to the law, rather than simply renew it upon expiration at the end of this year, echoes the viewpoint of Paul Macielak, chief executive of the New York Health Plan Association, who told Crain'slast month there needs to be more transparency in how HCRA money is spent. Bea Grause, president of the Healthcare Association of New York State, said in a statement responding to the report: "Altering HCRA or taking it away would have dramatic consequences for struggling hospitals statewide" due to the inadequacy of Medicare and Medicaid reimbursement. Changes would be "extremely difficult, especially given likely federal legislative and regulatory changes," Grause said. —J.L.

State adds online cannabis classes

New York is expanding its course offerings for clinicians and pharmacists who want to participate in the state's medical marijuana program. The state has awarded a two-year, $239,000 contract to TMCI Global to offer an alternate version of the 4.5-hour online course that's required for clinicians to register to prescribe cannabis in New York. It will become available in mid-2017, TMCI said. The state also secured a two-year, $239,000 contract with the current course vendor, the Answer Page. TMCI Global plans to offer continuing-education credits for pharmacists as well as doctors. New players are likely to enter other areas of the New York cannabis industry in its second year, despite slow growth. The state is seeking to double the number of licensed companies producing and selling cannabis from five to 10, and in late November it announced a solicitation for commercial labs to help test marijuana products. A spokeswoman for TMCI Global said its course will cost $229 for individuals, compared with the $249 the Answer Page currently charges for its course. —C.L.

AT A GLANCE

WHO'S NEWS: ColumbiaDoctors Obstetrics & Gynecology, a practice in Scarsdale led by Dr. Anna Burgansky, has joined NewYork-Presbyterian Medical Group Westchester. Burgansky also serves as the director of obstetrics and gynecology at NewYork-Presbyterian/Lawrence Hospital and is an assistant professor of obstetrics and gynecology at Columbia University Medical Center.

SMOKING'S TOLL: The cost of smoking on the global economy is massive and growing, according to a new study from the World Health Organization and the National Cancer Institute. The monograph, published Tuesday, said smoking costs the global economy more than $1 trillion each year in health care costs and lost productivity. By 2030, deaths from smoking are expected to grow by a third by 2030, to about 8 million annually, with more than 80% of the fatalities occurring in developing countries.

NONPROFIT OUTLOOK: S&P Global Ratings issued a report Tuesday, describing its outlook for the U.S. nonprofit health sector as "stable, but a pen stroke away from unprecedented change." The ratings agencies analysts wrote: "We believe the sector peaked in 2016 from a financial and operating metric perspective."

GREENER PASTURES: Bloomfield Industries, one of New York's five licensed cannabis companies, is being acquired by MedMen, a marijuana management and consulting firm in Los Angeles, Politico New York reported Monday.

How Trump's presidency might affect women's health in New York

Access to abortions, birth control, breast exams, pap tests and other reproductive-health services might be cut back or eliminated under the new administration in Washington, D.C. Some rights and funding for reproductive health are well protected under New York law, but others are not. Here's the rundown of what's at stake:

Access to Birth Control

The Affordable Care Act requires private health plans and most employers (excluding religious institutions) to cover FDA-approved birth control methods without requiring a patient co-pay. Eliminating patient co-pays has been associated with greater adherence to and continuation of oral contraception, according to a study last year published in Health Affairs. Repealing the ACA is a priority for Trump and congressional Republicans, but it's still unclear which aspects of the law will change, or when. One bill circulating in the New York Legislature, the Comprehensive Contraception Coverage Act, seeks to reinforce and ensure compliance with the ACA's insurance requirements for birth control coverage, and it has taken on new urgency for advocates since Trump's victory. The bill passed the state Assembly last January but never made it to a floor vote in the Senate.

"We want New York to be a safe haven for women's health care," said Jean Bucaria, deputy director of NOW NYC, the local chapter of the National Organization for Women.

Access to Reproductive Health Services

House Speaker Paul Ryan recently confirmed that Republicans in Congress will renew their efforts to defund Planned Parenthood. While the specific cuts will depend on the language used in the upcoming budget reconciliation bill, what's most likely at risk is access to services such as breast exams, pap tests, STD screenings and family planning for low-income women enrolled in Medicaid.

Planned Parenthood's approximately 60 New York clinics served more than 190,000 patients in 2015. Medicaid covered more than half of the patients who visited clinics in New York City. Some services covered by Medicaid, including STD testing, are split 50-50 between the state and federal governments. But for many services, the federal government picks up 90% of the tab.

"If we're not able to be reimbursed for those services, that creates a really big budget gap for us," said a spokeswoman for Planned Parenthood of New York City. She added that while private contributions have increased in response to recent threats from Congress, donations are not sufficient to cover the nearly $12 million in federal funds her chapter receives each year.

Although Medicaid in New York covers abortions, they are paid for exclusively with state funds and thus one of the few services not put at risk by Congress' defunding plans.

Right to an Abortion

Although restrictions on access have driven down abortions in many states, New York has the highest rate in the U.S., reporting 414 abortions per 1,000 live births in 2013, according to the U.S. Centers for Disease Control and Prevention.

President-elect Trump has vowed to appoint a Supreme Court judge who will tip the scales to overturn Roe v. Wade, the seminal decision that affirmed a woman's constitutional right to an abortion under the 14th amendment. If that were to happen, abortion rights in New York might be curtailed.

In 1970, three years before the Supreme Court ruling, New York's Republican-controlled Legislature legalized the procedure and extended access to women from other states. The law that was passed in New York, however, is somewhat more restrictive than the constitutional rights established under Roe v. Wade and other court cases. State law allows an abortion after 24 weeks only if it's a matter of life and death for the woman, while constitutional law allows a woman to get a late-stage abortion if an anomaly poses a serious risk to her health or makes the fetus unviable.

Tension between state and federal law has made it difficult for a woman in New York to find a provider to perform an abortion in the case of such an anomaly, said Donna Lieberman, executive director of the NYCLU, who noted that late-stage abortions are "as rare as they are tragic."

New York Attorney General Eric Schneiderman clarified last year that the rights established by Roe v. Wade should take precedence over state law, but Democrats in the New York Assembly have been trying for years to codify the rights established under the ruling, and they've been blocked at every turn by the Republican-controlled Senate.

There is another line of defense, though: Senate Minority Leader Chuck Schumer recently told the Huffington Post that Democrats in Congress would block any "out-of-the-mainstream nominee" for the Supreme Court, including someone who wants to overturn Roe v. Wade. —C.L.

Crain’s New York Business is the trusted voice of the New York business community—connecting businesses across the five boroughs by providing analysis and opinion on how to navigate New York’s complex business and political landscape.